Endoscopic biliary stenting is typically used to treat bile duct obstruction. In some cases, ERCP treatment of the bile duct fails or is not a viable treatment and surgery or percutaneous biliary drainage may be needed. However, surgery and percutaneous biliary drainage have a relatively high complication rate. Recently, transgastric endoscopic ultrasonography (EUS) has been used to provide imaging of the left lobe of the liver, especially of dilated intrahepatic ducts in patients with biliary obstruction. Using EUS guidance, biliary drainage can be provided by hepaticogastrostomy or choledochoduodenstomy approaches for placing a stent for biliary decompression. Hepaticogastrostomy or choledochoduodenstomy approaches have been shown to have lower complication rates than surgery or percutaneous drainage.
One potential complication of the hepaticogastrostomy or choledochoduodenstomy approach to treating biliary obstruction is the potential for bile to leak into the peritoneum. Bile leaks into the peritoneum when the bile flows outside of the wall of a stent placed between the hepatic biliary system (including extrahepatic bile ducts and/or intrahepatic bile ducts) and the stomach or the duodenum.
What is needed in the art is a prosthesis and a method for biliary decompression that minimizes the potential for peritoneal biliary leakage.